Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Cardiovascular Research Institute for Intractable Disease, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Int J Mol Sci. 2023 Mar 14;24(6):5556. doi: 10.3390/ijms24065556.
Advances in interventions after myocardial infarction (MI) have dramatically increased survival, but MI remains the leading cause of heart failure due to maladaptive ventricular remodeling following ischemic damage. Inflammation is crucial in both the initial response to ischemia and subsequent wound healing in the myocardium. To date, preclinical and clinical efforts have been made to elucidate the deleterious effects of immune cells contributing to ventricular remodeling and to identify therapeutic molecular targets. The conventional concept classifies macrophages or monocytes into dichotomous populations, while recent studies support their diverse subpopulations and spatiotemporal dynamicity. The single-cell and spatial transcriptomic landscapes of macrophages in infarcted hearts successfully revealed the heterogeneity of cell types and their subpopulations post-MI. Among them, subsets of Trem2 macrophages were identified that were recruited to infarcted myocardial tissue in the subacute phase of MI. The upregulation of anti-inflammatory genes was observed in Trem2 macrophages, and an in vivo injection of soluble Trem2 during the subacute phase of MI significantly improved myocardial function and the remodeling of infarcted mice hearts, suggesting the potential therapeutic role of Trem2 in LV remodeling. Further investigation of the reparative role of Trem2 in LV remodeling would provide novel therapeutic targets for MI.
心肌梗死后(MI)干预措施的进步显著提高了生存率,但由于缺血性损伤后适应性心室重构,MI 仍然是心力衰竭的主要原因。炎症在缺血的初始反应和随后的心肌伤口愈合中都很关键。迄今为止,已经进行了临床前和临床研究,以阐明导致心室重构的免疫细胞的有害作用,并确定治疗性分子靶点。传统概念将巨噬细胞或单核细胞分为两种群体,而最近的研究支持它们的多种亚群和时空动态性。在梗死心脏中的巨噬细胞的单细胞和空间转录组图谱成功揭示了细胞类型及其亚群在 MI 后的异质性。其中,在 MI 的亚急性期,鉴定出募集到梗死心肌组织的 Trem2 巨噬细胞亚群。在 MI 的亚急性期体内注射可溶性 Trem2 可显著改善心肌功能和梗死小鼠心脏的重构,表明 Trem2 在 LV 重构中的潜在治疗作用。进一步研究 Trem2 在 LV 重构中的修复作用将为 MI 提供新的治疗靶点。
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